Access to No-Cost Contraceptive Coverage After Open-Enrollment Period Depends on Plan

November 7, 2012 — Although many employer-sponsored health plans have open-enrollment periods this time of year, whether the plans have to offer no-cost contraceptive coverage depends on if they have made significant changes or have been granted grandfathered status, the Huffington Post reports.

The Affordable Care Act (PL 111-148) requires health plans issued or renewed after Aug. 1 to cover a slate of women's preventive services -- including contraception -- without copayments or deductibles. However, many women were not immediately affected because they were enrolled in plans that were already in effect at the time.

"About half of workers who have insurance through work are in a plan that is grandfathered" and did not have to offer the coverage, according to Alina Salganicoff, vice president and director of women's health policy for the Kaiser Family Foundation. However, she added, "Because all plans eventually change and employers change the plans they are using for workers, we are going to have fewer and fewer grandfathered plans."

Employers lose their grandfathered status if they switch insurance carriers or make significant changes to copays, deductibles and enrollment fees in their current plans. The Obama administration estimates that between 39% and 69% of employer-sponsored plans will lose their grandfathered status by 2013 (Pearson, Huffington Post, 11/5).